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Cox SR, Padmapriyadarsini C, Mave V, Seth B, Thiruvengadam K, Gaikwad S, Sahasrabudhe TR, Sane M, Tornheim JA, Shrinivasa BM, Lokhande R, Barthwal MS, Shivakumar SVBY, Krishnan S, Santhappan R, Kinikar A, Kakrani AL, Paradkar M, Bollinger RC, Sekar K, Gupte AN, Hanna LE, Gupta A, Golub JE. Characterising cause of death among people treated for drug-susceptible TB in India. Int J Tuberc Lung Dis 2023; 27:78-80. [PMID: 36853129 DOI: 10.5588/ijtld.22.0454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- S R Cox
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - C Padmapriyadarsini
- Indian Council of Medical Research-National Institute of Research in Tuberculosis, Chennai, India
| | - V Mave
- Johns Hopkins University School of Medicine, Baltimore, MD, USA, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University (BJGMC-JHU) Clinical Research Site, Pune, India, Johns Hopkins India, Pune, India
| | - B Seth
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - K Thiruvengadam
- Indian Council of Medical Research-National Institute of Research in Tuberculosis, Chennai, India
| | - S Gaikwad
- Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospital, Pune, India
| | - T R Sahasrabudhe
- Dr D. Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri-Chinchwad, India
| | - M Sane
- Johns Hopkins India, Pune, India
| | - J A Tornheim
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - B M Shrinivasa
- Indian Council of Medical Research-National Institute of Research in Tuberculosis, Chennai, India
| | - R Lokhande
- Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospital, Pune, India
| | - M S Barthwal
- Dr D. Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri-Chinchwad, India
| | | | - S Krishnan
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R Santhappan
- Indian Council of Medical Research-National Institute of Research in Tuberculosis, Chennai, India
| | - A Kinikar
- Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospital, Pune, India
| | - A L Kakrani
- Dr D. Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pimpri-Chinchwad, India
| | - M Paradkar
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University (BJGMC-JHU) Clinical Research Site, Pune, India, Johns Hopkins India, Pune, India
| | - R C Bollinger
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - K Sekar
- Indian Council of Medical Research-National Institute of Research in Tuberculosis, Chennai, India
| | - A N Gupte
- Boston University School of Public Health, Boston, MA, USA
| | - L E Hanna
- Indian Council of Medical Research-National Institute of Research in Tuberculosis, Chennai, India
| | - A Gupta
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J E Golub
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Shivakumar SVBY, Padmapriyadarsini C, Chavan A, Paradkar M, Shrinivasa BM, Gupte A, Dhanasekaran K, Thomas B, Suryavanshi N, Dolla CK, Selvaraju S, Kinikar A, Gaikwad S, Kohli R, Sivaramakrishnan GN, Pradhan N, Hanna LE, Kulkarni V, DeLuca A, Cox SR, Murali L, Thiruvengadam K, Raskar S, Ramachandran G, Golub JE, Gupte N, Mave V, Swaminathan S, Gupta A, Bollinger RC. Concomitant pulmonary disease is common among patients with extrapulmonary TB. Int J Tuberc Lung Dis 2022; 26:341-347. [PMID: 35351239 PMCID: PMC8982647 DOI: 10.5588/ijtld.21.0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND : Microbiologic screening of extrapulmonary TB (EPTB) patients could inform recommendations for aerosol precautions and close contact prophylaxis. However, this is currently not routinely recommended in India. Therefore, we estimated the proportion of Indian patients with EPTB with microbiologic evidence of pulmonary TB (PTB). METHODS : We characterized baseline clinical, radiological and sputum microbiologic data of 885 adult and pediatric TB patients in Chennai and Pune, India, between March 2014 and November 2018. RESULTS : Of 277 patients with EPTB, enhanced screening led to the identification of 124 (45%) with concomitant PTB, including 53 (19%) who reported a cough >2 weeks; 158 (63%) had an abnormal CXR and 51 (19%) had a positive sputum for TB. Of 70 participants with a normal CXR and without any cough, 14 (20%) had a positive sputum for TB. Overall, the incremental yield of enhanced screening of patients with EPTB to identify concomitant PTB disease was 14% (95% CI 12–16). CONCLUSIONS : A high proportion of patients classified as EPTB in India have concomitant PTB. Our results support the need for improved symptom and CXR screening, and recommends routine sputum TB microbiology screening of all Indian patients with EPTB.
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Affiliation(s)
| | - C Padmapriyadarsini
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - A Chavan
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - M Paradkar
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - B M Shrinivasa
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - A Gupte
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - K Dhanasekaran
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - B Thomas
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - N Suryavanshi
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - C K Dolla
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - S Selvaraju
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - A Kinikar
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - S Gaikwad
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - R Kohli
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - G N Sivaramakrishnan
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - N Pradhan
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - L E Hanna
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - V Kulkarni
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - A DeLuca
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - S R Cox
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - L Murali
- District Tuberculosis Office, Thiruvallur, India
| | - K Thiruvengadam
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - S Raskar
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India
| | - G Ramachandran
- Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India
| | - J E Golub
- Johns Hopkins School of Medicine, Baltimore, MD, USA, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - N Gupte
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - V Mave
- Johns Hopkins India, Pune, India, Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - A Gupta
- Johns Hopkins School of Medicine, Baltimore, MD, USA, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - R C Bollinger
- Johns Hopkins School of Medicine, Baltimore, MD, USA, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Cox SR, Gupte AN, Thomas B, Gaikwad S, Mave V, Padmapriyadarsini C, Sahasrabudhe TR, Kadam D, Gupte N, Hanna LE, Kagal A, Paradkar M, Thiruvengadam K, Jain D, Atre S, Sekar K, Raskar S, Shivakumar SVBY, Santhappan R, Deshmukh S, Pradhan N, Kulkarni V, Kakrani A, Barthwal MS, Sawant T, DeLuca A, Suryavanshi N, Chander G, Bollinger R, Golub JE, Gupta A. Unhealthy alcohol use independently associated with unfavorable TB treatment outcomes among Indian men. Int J Tuberc Lung Dis 2021; 25:182-190. [PMID: 33688806 DOI: 10.5588/ijtld.20.0778] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Approximately 10% of incident TB cases worldwide are attributable to alcohol. However, evidence associating alcohol with unfavorable TB treatment outcomes is weak.METHODS: We prospectively evaluated men (≥18 years) with pulmonary TB in India for up to 24 months to investigate the association between alcohol use and treatment outcomes. Unhealthy alcohol use was defined as a score of ≥4 on the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) scale at entry. Unfavorable TB treatment outcomes included failure, recurrence, and all-cause mortality, analyzed as composite and independent endpoints.RESULTS: Among 751 men, we identified unhealthy alcohol use in 302 (40%). Median age was 39 years (IQR 28-50); 415 (55%) were underweight (defined as a body mass index [BMI] <18.5 kg/m²); and 198 (26%) experienced an unfavorable outcome. Unhealthy alcohol use was an independent risk factor for the composite unfavorable outcome (adjusted incidence rate ratio [aIRR] 1.47, 95% CI 1.05-2.06; P = 0.03) and death (aIRR 1.90, 95% CI 1.08-3.34; P = 0.03), specifically. We found significant interaction between AUDIT-C and BMI; underweight men with unhealthy alcohol use had increased risk of unfavorable outcomes (aIRR 2.22, 95% CI 1.44-3.44; P < 0.001) compared to men with BMI ≥18.5 kg/m² and AUDIT-C <4.CONCLUSION: Unhealthy alcohol use was independently associated with unfavorable TB treatment outcomes, highlighting the need for integrating effective alcohol interventions into TB care.
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Affiliation(s)
- S R Cox
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA
| | - A N Gupte
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA
| | - B Thomas
- National Institute of Research in Tuberculosis (NIRT), Chennai
| | - S Gaikwad
- Byramjee Jeejeebhoy Government Medical College (BJGMC) and Sassoon General Hospital, Pune
| | - V Mave
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, BJGMC Clinical Research Site, Pune
| | | | - T R Sahasrabudhe
- Dr DY Patil Medical College Hospital and Research Centre, Dr DY Patil Vidyapeeth, Pune
| | - D Kadam
- Byramjee Jeejeebhoy Government Medical College (BJGMC) and Sassoon General Hospital, Pune
| | - N Gupte
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, BJGMC Clinical Research Site, Pune
| | - L E Hanna
- National Institute of Research in Tuberculosis (NIRT), Chennai
| | - A Kagal
- Byramjee Jeejeebhoy Government Medical College (BJGMC) and Sassoon General Hospital, Pune
| | - M Paradkar
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, BJGMC Clinical Research Site, Pune, Johns Hopkins India Private Limited, Pune, India
| | - K Thiruvengadam
- National Institute of Research in Tuberculosis (NIRT), Chennai
| | - D Jain
- BJGMC Clinical Research Site, Pune
| | - S Atre
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, Dr DY Patil Medical College Hospital and Research Centre, Dr DY Patil Vidyapeeth, Pune, Johns Hopkins India Private Limited, Pune, India
| | - K Sekar
- National Institute of Research in Tuberculosis (NIRT), Chennai
| | - S Raskar
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, BJGMC Clinical Research Site, Pune, Johns Hopkins India Private Limited, Pune, India
| | - S V B Y Shivakumar
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, Johns Hopkins India Private Limited, Pune, India
| | - R Santhappan
- National Institute of Research in Tuberculosis (NIRT), Chennai
| | - S Deshmukh
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, BJGMC Clinical Research Site, Pune, Johns Hopkins India Private Limited, Pune, India
| | - N Pradhan
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, BJGMC Clinical Research Site, Pune, Johns Hopkins India Private Limited, Pune, India
| | - V Kulkarni
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, BJGMC Clinical Research Site, Pune, Johns Hopkins India Private Limited, Pune, India
| | - A Kakrani
- Dr DY Patil Medical College Hospital and Research Centre, Dr DY Patil Vidyapeeth, Pune
| | - M S Barthwal
- Dr DY Patil Medical College Hospital and Research Centre, Dr DY Patil Vidyapeeth, Pune
| | - T Sawant
- Dr DY Patil Medical College Hospital and Research Centre, Dr DY Patil Vidyapeeth, Pune
| | - A DeLuca
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA
| | - N Suryavanshi
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA, BJGMC Clinical Research Site, Pune, Johns Hopkins India Private Limited, Pune, India
| | - G Chander
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA
| | - R Bollinger
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA
| | - J E Golub
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA
| | - A Gupta
- Johns Hopkins University (JHU), School of Medicine, Baltimore, USA
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Suryavanshi N, Sane M, Gaikwad S, Paradkar M, Mave V, Chandrasekaran P, Shivakumar SVBY, Gupta A, Gupte N, Thomas B. Assessment of persistent depression among TB patients. Int J Tuberc Lung Dis 2020; 24:1208-1211. [PMID: 33172530 DOI: 10.5588/ijtld.20.0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- N Suryavanshi
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
| | - M Sane
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
| | - S Gaikwad
- Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - M Paradkar
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
| | - V Mave
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - P Chandrasekaran
- National Institute for Research in Tuberculosis, Indian Council of Medical Research, Chennai, India
| | - S V B Y Shivakumar
- Johns Hopkins University, Center for Clinical Global Health Education, India Office, Pune, India
| | - A Gupta
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - N Gupte
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - B Thomas
- National Institute for Research in Tuberculosis, Indian Council of Medical Research, Chennai, India
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Gupte AN, Selvaraju S, Paradkar M, Danasekaran K, Shivakumar SVBY, Thiruvengadam K, Dolla C, Shivaramakrishnan G, Pradhan N, Kohli R, John S, Raskar S, Jain D, Momin A, Subramanian B, Gaikwad A, Lokhande R, Suryavanshi N, Gupte N, Salvi S, Murali L, Checkley W, Golub JE, Bollinger R, Chandrasekaran P, Mave V, Gupta A. Respiratory health status is associated with treatment outcomes in pulmonary tuberculosis. Int J Tuberc Lung Dis 2020; 23:450-457. [PMID: 31064624 DOI: 10.5588/ijtld.18.0551] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
<sec id="st1"> <title>BACKGROUND</title> The association between respiratory impairment and tuberculosis (TB) treatment outcomes is not clear. </sec> <sec id="st2"> <title>METHODS</title> We prospectively evaluated respiratory health status, measured using the Saint George's Respiratory Questionnaire (SGRQ), in a cohort of new adult pulmonary TB cases during and up to 18 months following treatment in India. Associations between total SGRQ scores and poor treatment outcomes of failure, recurrence and all-cause death were measured using multivariable Poisson regression. </sec> <sec id="st3"> <title>RESULTS</title> We enrolled 455 participants contributing 619 person-years at risk; 39 failed treatment, 23 had recurrence and 16 died. The median age was 38 years (interquartile range 26-49); 147 (32%) ever smoked. SGRQ scores at treatment initiation were predictive of death during treatment (14% higher risk per 4-point increase in baseline SGRQ scores, 95%CI 2-28, P = 0.01). Improvement in SGRQ scores during treatment was associated with a lower risk of failure (1% lower risk for every per cent improvement during treatment, 95%CI 1-2, P = 0.05). Clinically relevant worsening in SGRQ scores following successful treatment was associated with a higher risk of recurrence (15% higher risk per 4-point increase scores, 95%CI 4-27, P = 0.004). </sec> <sec id="st4"> <title>CONCLUSION</title> Impaired respiratory health status was associated with poor TB treatment outcomes. The SGRQ may be used to monitor treatment response and predict the risk of death in pulmonary TB. </sec>.
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Affiliation(s)
- A N Gupte
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - S Selvaraju
- National Institute for Research in Tuberculosis, Chennai
| | - M Paradkar
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune
| | - K Danasekaran
- National Institute for Research in Tuberculosis, Chennai
| | | | | | - C Dolla
- National Institute for Research in Tuberculosis, Chennai
| | | | - N Pradhan
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune
| | - R Kohli
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune
| | - S John
- National Institute for Research in Tuberculosis, Chennai
| | - S Raskar
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune
| | - D Jain
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune
| | - A Momin
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune
| | - B Subramanian
- National Institute for Research in Tuberculosis, Chennai
| | - A Gaikwad
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune
| | - R Lokhande
- Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune
| | - N Suryavanshi
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, Pune
| | - N Gupte
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - S Salvi
- Chest Research Foundation, Pune, India
| | - L Murali
- National Institute for Research in Tuberculosis, Chennai
| | - W Checkley
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - J E Golub
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - R Bollinger
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - V Mave
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A Gupta
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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6
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Shivakumar SVBY, Chandrasekaran P, Kumar AMV, Paradkar M, Dhanasekaran K, Suryavarshini N, Thomas B, Kohli R, Thiruvengadam K, Kulkarni V, Hannah LE, Sivaramakrishnan GN, Pradhan N, Dolla C, Gupte A, Ramachandran G, DeLuca A, Meshram S, Bhardawaj R, Bollinger RC, Golub J, Selvaraj K, Gupte N, Swaminathan S, Mave V, Gupta A. Diabetes and pre-diabetes among household contacts of tuberculosis patients in India: is it time to screen them all? Int J Tuberc Lung Dis 2019; 22:686-694. [PMID: 29862955 DOI: 10.5588/ijtld.17.0598] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Pre-diabetes mellitus (pre-DM) and DM increase the risk of developing tuberculosis (TB). Screening contacts of TB patients for pre-DM/DM and linking them to care may mitigate the risk of developing TB and improve DM management. OBJECTIVE To measure the prevalence of pre-DM/DM and associated factors among the adult household contacts (HHCs) of pulmonary TB patients. METHODS Between August 2014 and May 2017, adult HHCs of newly diagnosed adult PTB patients in Pune and Chennai, India, had single blood samples tested for glycosylated haemoglobin (HbA1c) at enrolment. DM was defined as previously diagnosed, self-reported DM or HbA1c 6.5%, and pre-DM as HbA1c between 5.7% and 6.4%. Latent tuberculous infection (LTBI) was defined as a positive tuberculin skin test (5 mm induration) or QuantiFERON® Gold In-Tube (0.35 international units/ml). RESULTS Of 652 adult HHCs, 175 (27%) had pre-DM and 64 (10%) had DM. Forty (64%) HHCs were newly diagnosed with DM and 48 (75%) had poor glycaemic control (HbA1c 7.0%). Sixty-eight (22%) pre-DM cases were aged 18-34 years. Age 35 years, body mass index 25 kg/m2, chronic disease and current tobacco smoking were significantly associated with DM among HHCs. CONCLUSIONS Adult HHCs of TB patients in India have a high prevalence of undiagnosed DM, pre-DM and LTBI, putting them at high risk for developing TB. Routine DM screening should be considered among all adult HHCs of TB.
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Affiliation(s)
| | - P Chandrasekaran
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, Paris, France
| | - M Paradkar
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - K Dhanasekaran
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - N Suryavarshini
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - B Thomas
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - R Kohli
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - K Thiruvengadam
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - V Kulkarni
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - L E Hannah
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - N Pradhan
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India
| | - C Dolla
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - A Gupte
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - G Ramachandran
- National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - A DeLuca
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - S Meshram
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - R Bhardawaj
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - R C Bollinger
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - J Golub
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - K Selvaraj
- Pondicherry Institute of Medical Sciences (PIMS), Puducherry
| | - N Gupte
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - S Swaminathan
- Indian Council of Medical Research, New Delhi, India
| | - V Mave
- Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research site, Pune, Maharashtra, India, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - A Gupta
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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